In the United States, overcrowding of Emergency Departments (EDs) occurs at least once per week in 90% of hospitals. ED overcrowding is correlated with poor health outcomes, resulting in a higher mortality rate or longer recovery time, such as due to a lack of timeliness and an inability to administer treatment. There are many causes of ED overcrowding, predominantly including high demand for radiology services. Such radiology services include 39 million X-rays provided for EDs each year. Many X-rays are acquired for patients with time-critical conditions (e.g., trauma, head injury, or stroke), and about 19 million are acquired for patients with suspected bone fractures.
For example, X-rays for bone fractures include 4 million patients per year who receive 2 X-ray sessions each, with 60% of these patients receiving two sets of X-rays per session (estimated using a percentage of displaced fractures). X-rays are also obtained for 3.2 million of the 5 million ED sprain patients per year (estimated using a statistic that 64% of ED sprains receive X-rays). Acquiring an X-ray for a patient in the ED is resource intensive and time consuming, and generally can involve the following: arrangement of time on the X-ray machine, transport of the patient to the X-ray machine, acquisition of the X-ray image, transport of the patient and the image results back to the ED, obtaining a disposition from a radiologist, and communication of the disposition to the ED or an orthopedic physician. For example, each ED-ordered X-ray consumes >30 minutes with an additional >30 minutes to acquire a radiologist disposition. Delay can also be compounded by the radiology backlog.